Provider Demographics
NPI:1760690515
Name:WURSCHMIDT, WILLIAM C (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:WURSCHMIDT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 PACHECO BLVD
Mailing Address - Street 2:
Mailing Address - City:PACHECO
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5126
Mailing Address - Country:US
Mailing Address - Phone:925-825-2855
Mailing Address - Fax:
Practice Address - Street 1:5500 PACHECO BLVD
Practice Address - Street 2:
Practice Address - City:PACHECO
Practice Address - State:CA
Practice Address - Zip Code:94553-5126
Practice Address - Country:US
Practice Address - Phone:925-825-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice